Abstract
IntroductionDamage to the cerebellar functional network may underlie anxiety symptoms in patients with Parkinson’s disease (PD). Herein we investigated the regional homogeneity (ReHo) and functional connectivity (FC) patterns of cerebellar and clinical correlates in PD patients with anxiety and explored their clinical significance.MethodsWe enrolled 50 newly diagnosed drug-naïve PD patients and 30 normal controls (NCs). Twenty-six PD patients with anxiety symptoms (PD-A) and 24 PD patients without anxiety symptoms (PD-NA) were sorted into groups based on the Hamilton Anxiety Scale (HAMA). All included participants underwent rest-state functional magnetic resonance imaging (rs-fMRI) scanning. Cerebellar FC based on the seed-based method was used to investigate regional and whole brain function in PD-A, PD-NA, and NCs, and the relationship between the abnormal brain function and anxiety symptoms in PD patients was also detected.ResultsCompared with the PD-NA group and the NCs, the ReHo value of the PD-A group was significantly decreased in the left medial frontal gyrus and increased in the left cerebellum. Further, left-cerebellum-based FC patterns were used to detect the decreased FC in the right cerebellum, while FC was increased in the right caudate nucleus, and the right anterior cingulate cortex (ACC) in the PD-A group was compared with that in the PD-NA group. Further, the altered FC between the left cerebellum and the right cerebellum was significantly associated with anxiety symptoms in the PD-A group.ConclusionThe present study found abnormal regional cerebellum function as well as disruptions in the connectivity network within the cerebellum, caudate, and ACC in patients with PD-A. In addition, the FC between the left cerebellum and the right cerebellum was associated with anxiety symptoms in patients with PD. The present study indicated that cerebellar functional damage may be associated with anxiety symptoms in PD patients.
Highlights
Parkinson’s disease (PD), the second most prominent chronic progressive neurodegenerative disease in middleaged and elderly people [1], has anxiety as one of its common neuropsychiatric symptoms
Anxiety symptoms were assessed according to the Hamilton Anxiety Scale (HAMA) Scale, including 26 PD-A patients (HAMA >12 points) and 24 PD-NA patients (HAMA
The analysis of variance (ANOVA) showed that regional homogeneity (ReHo) values of the left medial frontal gyrus and left cerebellum differed significantly among PD-A patients, PD-NA patients, and normal controls (NCs)
Summary
Parkinson’s disease (PD), the second most prominent chronic progressive neurodegenerative disease in middleaged and elderly people [1], has anxiety as one of its common neuropsychiatric symptoms. Studies have shown that up to 25–50% of the PD patients have varying degrees of anxiety [2]. It aggravates other motor symptoms, adversely affects the patient’s daily functioning and disease prognosis, reduces the patient’s quality of life, and increases the burden on the caregiver [3]. Patients meeting the following criteria were excluded: (a) progressive supranuclear paralysis, multiple system atrophy, vascular Parkinson’s syndrome, multiple system atrophy, and vascular Parkinson’s syndrome secondary parkinsonism; (b) MRI contraindications, such as claustrophobia, metal implants, and brain pathology or motor artifacts on MRI; and (c) depression symptoms with a score of ≥14 as per the Hamilton Depression Rating Scale (HAMD). Ethical approval: The research related to human use has been complied with all the relevant national regulations, institutional policies, and in accordance with the tenets of the Helsinki Declaration, and has been approved by the ethics committee of the Affiliated Hospital of North Sichuan Medical College (No 2019ER(R)016)
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